Do no do examples

Do no do examples for Fertility problems: assessment and treatment
Title Year published Impact Level
Women who are concerned about their fertility should not be offered a blood test to measure prolactin. December 2016 Unclassified
Women with possible fertility problems are no more likely than the general population to have thyroid disease and the routine measurement of thyroid function should not be offered. December 2016 Unclassified
Women should not be offered an endometrial biopsy to evaluate the luteal phase as part of the investigation of fertility problems because there is no evidence that medical treatment of luteal phase defect improves pregnancy rates. December 2016 Unclassified
Women should not be offered hysteroscopy on its own as part of the initial investigation unless clinically indicated because the effectiveness of surgical treatment of uterine abnormalities on improving pregnancy rates has not been established. December 2016 Unclassified
Do not offer sperm washing as part of fertility treatment for men with hepatitis B. December 2016 Unclassified
Men with leucocytes in their semen should not be offered antibiotic treatment unless there is an identified infection because there is no evidence that this improves pregnancy rates. December 2016 Unclassified
Men should not be offered surgery for varicoceles as a form of fertility treatment because it does not improve pregnancy rates. December 2016 Unclassified
For women who are taking clomifene citrate, do not continue treatment for longer than 6 months. December 2016 Unclassified
The use of adjuvant growth hormone treatment with gonadotrophin-releasing hormone agonist and/or human menopausal gonadotrophin during ovulation induction in women with polycystic ovary syndrome who do not respond to clomifene citrate is not recommended because it does not improve pregnancy rates. December 2016 Unclassified
Medical treatment of minimal and mild endometriosis diagnosed as the cause of infertility in women does not enhance fertility and should not be offered. December 2016 Unclassified
Post-operative medical treatment does not improve pregnancy rates in women with moderate to severe endometriosis and is not recommended. December 2016 Unclassified
Do not offer oral ovarian stimulation agents (such as clomifene citrate, anastrozole or letrozole) to women with unexplained infertility. December 2016 Unclassified
For people with unexplained infertility, mild endometriosis or mild male factor infertility, who are having regular unprotected sexual intercourse do not routinely offer intrauterine insemination, either with or without ovarian stimulation (exceptional circumstances include, for example, when people have social, cultural or religious objections to IVF) advise them to try to conceive for a total of 2 years (this can include up to 1 year before their fertility investigations) before IVF will be considered. December 2016 Unclassified
In women aged under 40 years who have not conceived after 2 years of regular unprotected intercourse or 12 cycles of artificial insemination (where 6 or more are by intrauterine insemination), offer 3 full cycles of IVF, with or without ICSI. If the woman reaches the age of 40 during treatment, complete the current full cycle but do not offer further full cycles. December 2016 Unclassified
When using gonadotrophins for ovarian stimulation in IVF treatment: use an individualised starting dose of follicle-stimulating hormone, based on factors that predict success, such as: age, BMI, presence of polycystic ovaries, ovarian reserve; do not use a dosage of follicle-stimulating hormone of more than 450 IU/day. December 2016 Unclassified
Do not use growth hormone or dehydroepiandrosterone (DHEA) as adjuvant treatment in IVF protocols. December 2016 Unclassified
Women who have developed at least 3 follicles before oocyte retrieval should not be offered follicle flushing because this procedure does not increase the numbers of oocytes retrieved or pregnancy rates, and it increases the duration of oocyte retrieval and associated pain. December 2016 Unclassified
Assisted hatching is not recommended because it has not been shown to improve pregnancy rates. December 2016 Unclassified
Women should be informed that bed rest of more than 20 minutes' duration following embryo transfer does not improve the outcome of IVF treatment. December 2016 Unclassified
Do not offer women natural cycle IVF treatment December 2016 Unclassified
There is insufficient evidence to recommend the use of gamete intrafallopian transfer or zygote intrafallopian transfer in preference to IVF in couples with unexplained fertility problems or male factor fertility problems. December 2016 Unclassified
Do not use a lower age limit for cryopreservation for fertility preservation in people diagnosed with cancer. December 2016 Unclassified
Do not use any of the following tests individually to predict any outcome of fertility treatment: ovarian volume, ovarian blood flow, inhibin B, oestradiol. December 2016 Unclassified
Screening for antisperm antibodies should not be offered because there is no evidence of effective treatment to improve fertility. December 2016 Unclassified
Men with idiopathic semen abnormalities should not be offered antioestrogens, gonadotrophins, androgens, bromocriptine or kinin-enhancing drugs because they have not been shown to be effective. December 2016 Unclassified
Women with polycystic ovary syndrome who are being treated with gonadotrophins should not be offered treatment with gonadotrophin-releasing hormone agonist concomitantly because it does not improve pregnancy rates, and it is associated with an increased risk of ovarian hyperstimulation. December 2016 Unclassified
Testing for Y chromosome microdeletions should not be regarded as a routine investigation before ICSI. However, it is likely that a significant proportion of male infertility results from abnormalities of genes on the Y chromosome involved in the regulation of spermatogenesis, and couples should be informed of this. December 2016 Unclassified
The routine use of post-coital testing of cervical mucus in the investigation of fertility problems is not recommended because it has no predictive value on pregnancy rate. December 2016 Unclassified
The use of basal body temperature charts to confirm ovulation does not reliably predict ovulation and is not recommended. December 2016 Unclassified
Advise couples that if all the criteria in recommendation 1.3.10.2 are met, sperm washing may not further reduce the risk of infection and may reduce the likelihood of pregnancy. December 2016 Unclassified
Replacement of embryos into a uterine cavity with an endometrium of less than 5 mm thickness is unlikely to result in a pregnancy and is therefore not recommended. December 2016 Unclassified
Inform women undergoing IVF treatment that the evidence does not support continuing any form of treatment for luteal phase support beyond 8 weeks' gestation. December 2016 Unclassified
Inform couples that there is insufficient evidence to recommend that HIV negative women use pre-exposure prophylaxis, when all the criteria in recommendation 1.3.10.2 are met. December 2016 Unclassified